Your Mind is a Terrible Thing to Waste, and Your Waist is a Relevant Thing to Mind

When it comes to compelling reasons for doing what you can to maintain a healthy weight and avoid obesity, it’s hard to top “You’ll live longer” and “You’ll feel better physically.” But “You’ll lower your risk of mental deterioration and Alzheimer’s” is starting to look like a serious contender. I suspect that a lot of people who have let their bodies go might not have done so if they believed they could be letting their minds go in the process. But there are studies that indicate that healthy body/healthy mind may indeed be the real deal.

The Alzheimer’s Association, whose central mission is to know as much as possible about the causes of the disease, seems to have come to that conclusion after conducting a meta review of research results. It’s the AA’s position that the risk of age-related cognitive decline, including dementia and Alzheimer’s, may be materially reduced by keeping physically fit through exercise and weight management. In short, the same lifestyle that produces cardiovascular health enhances neurological health as well.

Statistical analyses have found that populations whose members exercise regularly, eat healthily and stay mentally active are less likely to experience cognitive decline over the years, but the research most commonly cited in this regard is the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, a laborious title which is shortened in the literature to the FINGER Study.

The Finns took 1,260 men and women aged 60 to 77 whose scores on memory and cognitive performance tests were average or below, and split them into two groups, one placed in a healthy lifestyle program that emphasized a nutritious, low-fat and low-sugar diet, and the other that was simply given general health advice. Two years later, the enhanced lifestyle group had boosted its memory and cognitive skills by 25 percent compared to the control group.

Weight Loss Helps You Gain Brain Skills

How much of that 25 percent is attributable to dietary weight control is not clear, because the lifestyle program included physical strength training and regular walking, jogging or other aerobic exercise and cognitive training sessions on computers three times a week. As evidence that weight played a part, a study published last year by Brazilian researchers addressed the issue of obesity and dementia head-on by taking 80 obese individuals aged 60 or above who were diagnosed with mild cognitive impairment and providing them with a nutrition counselor who gave them ongoing weight-control advice.

After one year, those who had lost weight to any degree exhibited improved cognitive skills such as word retention, focused attentiveness and multi-tasking. Almost any BMI decrease, they reported, “was associated with improvements in verbal memory, verbal fluency, executive function, and global cognition, after adjustment for education, gender, physical activity, and baseline tests.”

Even so, the approach to a maintaining one’s mental acuity over time is more holistic than merely being of normal weight. Physical activity is also a significant element: a well-regarded study by Stockholm researchers, for example, determined that regular running is associated with increased cell growth in the hippocampus, a key contributor to the brain’s learning and memory functions.

And perhaps most important, simply using your mind on a daily basis—applying it to tasks and challenges—could be your best defense and delaying action against mental decline. A two-year Johns Hopkins study found that individuals 60 and older who did volunteer work in central city schools as tutors and teachers’ aides experienced actual increases in hippocampus volume, compared to some shrinkage among those in a control group.

If you’re smart, you’ll hold yourself to a healthy weight, get regular exercise and stay mentally active. More to the point, if you do all that, you’ll stay smart.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

Years ago, prior to the Olympic games, I heard an ongoing story on sports news about how our decathlon athletes were the best in the world. This was to entice us to watch the upcoming event. As I remember, they didn’t even finish in the top ten. My motto that year became “Just tell me the truth!” After seeing a study on subjects lying to researchers who were studying smokers in a stop-smoking program, I imagine my motto has become very popular with the research community also!

The Study

“Accuracy of self-reported smoking abstinence in clinical trials of hospital-initiated smoking interventions,” published in the August 2017 issue of the journal Addiction, found that a high proportion of smokers enrolled in stop-smoking programs during a hospital stay reported having quit when in fact they had not.

This study looked at five large smoking cessation clinical trials in the United States that enrolled smokers at hospitalization and surveyed 4,206 participants during the six-month follow-up. Of these, 822 participants claimed not to have smoked in the past seven days. However in reality, 333 of these self-reported quitters were lying.

We know this because as part of the study agreement, the subjects provided a saliva sample for testing. Nicotine from cigarettes is rapidly converted in the body to a chemical called cotinine, which has a much longer half-life, so the presence of this chemical is a very accurate measure of whether someone has smoked in the past few days. More than 40 percent, or 333 of the subjects, failed the saliva test.

The lying rate may be even higher because, despite the offer of $50 to $100 for providing a sample, 18.6 percent of people who had said they had quit smoking did not reply, even after multiple requests. Because of this, these participants were excluded from the study. The study also excluded anyone who said they were using another nicotine product such as smokeless tobacco, nicotine patches or e-cigarettes. Because of the specificity of the test, even exposure to second-hand smoke would not have raised cotinine levels to those found in this study.

Lead author Dr. Taneisha Scheuerman says, “Our study shows that in studies where participants may feel pressure to say they have quit when they have not, it is essential to verify claims of quitting using an objective test such as cotinine to know true quit rates.”

The findings demonstrate that in these kinds of studies, it is vital to check claims of having quit using an objective measure.

It isn’t Just Lying in Stop-smoking Programs

After reading that study, I decided to look further into subjects lying in research. It turns out, it is not just in stop-smoking programs, but is rampant in any study that relies on self-reported data, especially if the study is looking at a situation that involves any addiction, including alcohol, drugs, gambling and so forth.

It is no wonder than those who are in close relationships with addicts are constantly faced with their lies. They are very good at hiding the truth about what they have been doing and how they have been living because they must lie in order to prevent others from discovering the unfortunate truth about their dependency. Addicts lie constantly to protect themselves from the consequences of their actions.

If it sometimes seems like they are dishonest about everything, that is because their entire existence is centered around one major lie. Eventually, lying becomes second nature. The only good way out of this problem is for the addict to face the truth about their life and accept the consequences, and then begin their road to recovery. Even then, it is difficult because lying has become a habit that must be broken and replaced with honesty.

It isn’t Just Lying by Humans

Curiosity led me to look into lying in the animal world, where in fact, it is quite common, although it may be termed misdirection or deception.

I found a study on the development of cooperative behavior in apes and monkeys where the scientists believe the animals developed the ability to lie and deceive in order to form coalitions, get food and mate.

The researchers claim, “Ultimately, our ability to convincingly lie to each other may have evolved as a direct result of our cooperative nature, and…deception is still rife in the animal kingdom.”

As for humans, the potential for lying increased even further because of our evolution of language. To quote Robert Wright, author of “The Moral Animal”:

“We are far from the only dishonest species, but we are surely the most dishonest, if only because we do the most talking.”

And writing!

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Consumers Want Sweetened Drinks, Just Not with Any of the Current Sweeteners

What follows are excerpts from an actual press release issued by the Coca-Cola company, interspersed with my own translations, interpretations, and elaborations.

Coca-Cola is expanding its pursuit of all-natural low- or no-calorie sugar alternatives with the launch of two sweetener challenges on the HeroX crowdsourcing platform. And the company is sweetening the pot in both competitions by putting up potential prize money.

The press release notes that Coke is “looking for new beverage ingredients to meet consumers’ evolving tastes and lifestyles.” This is only partly true. Consumers’ lifestyles are indeed changing, and those new lifestyles frequently do not include the consumption of sugary foods and beverages. As one industry analyst told NPR, “Sugar is now the number one item that consumers want to avoid in their diets.”

People Want Sugar without the Sugar

That’s great news, unless you’re in the sweetened beverage business. Because while consumers’ lifestyles are evolving, their tastes, in a very literal sense, are not. They may not want sugar’s calories, but they still want its taste and texture.

Robert Long, SVP and chief innovation officer at Coca-Cola, said the company is pleased with the range of low- and no-calorie sweeteners it uses in its beverages around the world, including stevia.

But not so pleased that it isn’t willing to desperately resort to crowdsourcing and dangling possible prize money in hopes of finding something better. That’s because every single artificial sweetener Coke and its Big Soda brethren have tried using to replace sugar has wound up having deal-killing drawbacks, including stevia. From saccharin to aspartame, they have been variously linked to cancer, type 2 diabetes, insulin spikes, cravings and, despite having zero calories, weight gain.

Mind you, the beverage industry could live with all that, but what it can’t abide is the fatal flaw that none of these man-made sweeteners tastes and feels in the mouth like sugar. And it is sugar that we evolved to seek out for vital energy as fruit-eating primates; our love for sugar’s blend of sucrose and fructose goes back even further than we do. The soda industry thought it had the solution with stevia, a super sweet, zero-cal, natural plant extract. But stevia leaves a nagging bitter aftertaste and has made some people nauseous.

If You’ve Got Something Better, Don’t Give it to Coke

Coke did manage to improve stevia’s aftertaste somewhat by adding a special ingredient. The special ingredient was…sugar. Alas, when it comes to sugar, “accept no substitutes” seems instilled in our DNA. Yet that is just what Coke is flailing around for: an acceptable sugar substitute. That’s what their “two sweeteners challenges” are all about.

The “sweet story challenge” invites people around the world to submit written anecdotes and videos about their favorite, tried-and-true methods of naturally sweetening foods or beverages in their cultures, communities or families. Up to five individual or team winners will vie for $100,000 in total prize money, with winners announced in December.

I don’t know about you, but I’m not aware that my culture, community or family ever developed any method of naturally sweetening our foods and drinks. I’m not even sure I have a culture or community. If you have one of those, and it happened to come up with such a natural sweetener, my advice is to play hardball with the Coca-Cola folks. That’s because Professor Paul Breslin of Rutgers University’s nutritional science department called Coke’s Hail Mary request “a hundred-million dollar question, because it’s so difficult and so potentially lucrative.”

If his appraisal of a winning sweetener’s financial value is correct, Coke is trying to pick your pocket. Solve their problem for them, and they will graciously tip you one-tenth of one percent of their eventual take. You could get a better deal from a Nigerian email scammer. But Coke doesn’t really expect you, a mere civilian, to come through for them. That leads us to Plan B.

A second challenge is a call to action for researchers and scientists to find a naturally sourced, safe, low- or no-calorie compound that creates the taste sensation of sugar when used in beverages and foods. One grand prize winner will be awarded $1 million in October 2018.

I’m sure that any researchers and scientists ingenious and brilliant enough to come up with such a compound will rush right over to Coca-Cola headquarters to claim their million bucks. That is, right after they’ve made a stop at the U.S. Patent Office.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

]]>http://calorielab.com/news/2017/09/18/cokes-offer-1-million-reward-for-an-acceptable-sugar-substitute/feed/0What Are You Gonna Do When the Hurricane’s Doing You?http://calorielab.com/news/2017/09/15/what-are-you-gonna-do-when-the-hurricanes-doing-you/
http://calorielab.com/news/2017/09/15/what-are-you-gonna-do-when-the-hurricanes-doing-you/#commentsFri, 15 Sep 2017 14:00:37 +0000http://calorielab.com/news/?p=26420

(CC BY-SA 2.0) by Air Force Magazine/Flickr

As you know, the whole state of Florida was hit by Hurricane Irma. What you probably don’t know is that the actual wind storm itself was just the beginning of our Irma-geddon. Sure, it was a category 4 monster that fortunately (for us) hit Cuba first to knock some of the power out of it.

Then it went north over the peninsula of Florida to take a lot more of the force of the storm away, but as all of those who have been in hurricanes learn, that is just the beginning of the nightmare.

Too Much Water and Poser

Along with the wind damage comes flooding from all the rain and storm surge, which not only floods the coastal areas but all areas fed by inland rivers. Then on top of that, because of downed power lines and flooding, electric power has gone out for millions of homes and businesses.

I suppose all this would be fine except that millions of people were under forced evacuation orders, so all the major highways that were filled and moving at a crawl north before the storm are now the same, except the crowds are heading south.

That would also be fine except that cars, trucks and generators need gas, which has been in short supply since before the storm hit, and now it’s worse.

Too Little Power and Water

If you were lucky enough not to have to be on the move, you hunkered down at home initially. Then the power goes out, and since many of us have well water (although it also affects those on city water in many places) along with power loss, there is no water.

That means, unless you planned ahead, none for drinking or anything else like bathing or using that amazing invention, the flush toilet.

If you were smart enough to plan ahead, you still have to carry many, many buckets of water to make it function. Water can be quite heavy and tedious to carry.

In a hurricane, the best you can do is function at a second-world level, because you can forget first-world accommodations. That includes a working fridge and freezer, and of course an air conditioner, let alone a computer.

So that’s pretty much the way it is for me at this point. I’m certainly not writing this column with all the resources and conveniences I usually have at my fingertips.

The Really Bad

Well, that’s most of the bad, that is if you are healthy and fit. But if that is not the case, everything is worse, and you have more things to worry about, like obtaining unspoiled food, fresh water, needed medicines and the like.

The Really Good

The best part of this experience has been the kindness and caring that people have been showing each other. There have been countless stories of people coming to the aid of others in distress, neighbors helping neighbors, friends helping friends and strangers helping strangers.

That’s pretty much all I have this week. I’ve got lots of work ahead of me to do here, but it will get done. It is a challenge, I’m not gonna lie.

It’s one thing to be patient, like when you are sitting in the waiting room leafing through a five-year-old magazine at your doctor’s office. It’s quite another thing to be patient when you are hot, tired, bored, your roof is leaking and your toilet won’t flush.

So, to answer my original question: you do the best you can!

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Few Real Surprises…Until We Get to Politics

It’s no secret that the United States is unhealthily fat, with a national obesity rate surpassing 30 percent. But it’s also no secret that the 50 individual states are not equally beset by excess flesh. As of 2016, the numbers for which are just becoming clear, the obesity rates range from more than 37 percent in West Virginia and Mississippi, and more than 35 percent in Alabama, Arkansas and Louisiana, to below 23 percent in Colorado and the District of Columbia and less than 24 percent in Massachusetts and Hawaii. I am proud, relatively speaking, that my own state of California comes in fifth on the Slender Derby, with an obesity rate of 25 percent.

As the updated 2016 data fills out, a number of other demographic breakdowns illustrate the reality that, along with nationwide income inequality, we are in the grip of nationwide outspread inequality. We are distinctly more, or less, statistically likely to be significantly overweight depending on our educational background, racial and/or ethnic status, geographical location and more.

Geography is Destiny, But So is Age

Start with locale. As has been the case for years, with the exception of West Virginia, seven of the ten heaviest states are former members of the Confederacy, and a mere glance at the latest national obesity map confirms that our most overweight residents are concentrated in the southeast. Broken down by region, the obesity rates are 32 percent for the southeast, 31.4 percent for the midwest, 26.9 percent for the northeast and 26 percent for the west.

When it comes to age and obesity, there is a kind of bell curve, whose message is that the cliche, “middle-age spread,” is no cliche after all. The obesity rate rises from 17.3 percent for those in the 18-24 bracket, and peaks at more than double that, 35.1 percent, among those aged 45-54 before tapering off. There are several possible reasons for this yawning obesity gap between the Millenials and the Gen Xers.

Young adults may consume more fast food and junk food, but are less able to afford sumptuous sit-down restaurant meals, which tend to be the worst in terms of calorie load and carbohydrates.

Young adults offset their dietary excesses by being far more physically active than their parents’ generation.

Young adults are better informed when it comes to nutrition and dietary health and less locked into eating habits based on proven misconceptions (fat bad, carbs fine, etc.) than their elders.

These rates are based on self-reporting, and young adults, or at least the overweight ones, are a pack of liars.

Knowledge is Helpful

I expect there is some measure of truth to all of these takes, but I think the sleeper here may be number three: the young are more knowledgeable when it comes to diet, exercise and health in general. That’s partly because the young tend to be more knowledgeable than previous generations overall. More complete high school, attend college, and graduate therefrom than in the past.

That’s significant because there is an inverse correlation with educational level and obesity rate across the board. Adults who lack a high school degree or its equivalent have an obesity rate of 35.5 percent, and that’s self-reported. That number declines to 32.3 percent for high school grads, 31 percent for college attendees, and a mere 22.2 percent for those who got a diploma. Just in itself, this trend line is a terrific argument for ongoing education.

My friend Doctor Jim, not to be confused with my esteemed colleague Dr. J, speculates that sheer student debt has left most college grads too financially strapped to afford much more than basic nutrition, but if that were the case, I assume it would be reflected in a broader association between low-income groups and low obesity rates. And that premise is not supported by the racial/ethnic obesity numbers: 38.3 percent for non-Hispanic blacks, 32.5 percent for Hispanics, and 28.1 percent for non-Hispanic whites.

I realize that I open myself to charges of stereotyping—minorities are all poor—but I haven’t seen any data specifically breaking down obesity rates by income, and I think we all know what the economic realities are in the U.S.A. Anyway, if you find that observation to be controversial, you’ll love what comes next.

The press releases accompanying the latest fat stats don’t mention the fact, but there is a political association that, whether weirdly coincidental or not, is downright spooky. Very simply, if you voted Republican last year, it’s a good bet that you buy off the XXL rack.

Get this: with the only exceptions being number 10 Illinois and number 23 Delaware, every one of the 25 states with the highest obesity rates went for Trump.

And it’s not just a far-right southern red state thing; Wisconsin, Michigan, Ohio and Pennsylvania are in the fattest states mix. The Obesity Map and Electoral College Map aren’t twins, but the resemblance is uncanny. The main difference between the two is that the 25 least obese states did not overwhelmingly break in the same way for Clinton. If they had, she could have won.

I can think of several explanations for this linkage, but I hate getting e-mail that begins, “You (crude unprintable epithet)…” I’m somewhat baffled that the heftiest states embraced the candidate who had repeatedly expressed a dislike for fatness, especially of the female variety. Then again, Donald is no Weight Watchers “after” photo; maybe voters of a certain size simply identified with him.

I’m wondering if there might be a market for baseball caps bearing the slogan, “Make America Slim Again.”

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

The college football season just started. I’ve described football as the consummate, ideal American game: a tight group of people all working rigidly together to achieve a future goal. Perhaps that is what differentiates us from those countries, as in the rest of the world, where fútbol (soccer) is their national game. There we have two loosely organized groups of people running all over the place and occasionally stopping when the ball goes into one of two nets.

The Fans

If you live in the South, the loyalty hierarchy for many people goes God – Country – Family – Football, with family and football often trading places. After all, fan is short for fanatic. Believe me, we have people here who, near the moment of their death, would see the life of football flash before their eyes. For them, the bond to football is like their infant bond to their mothers except they have yet to go through the separation stage. I see this played out every time a team loses as fans take it as a personal loss and suffer inappropriately, often assigning blame to everything they can.

I suppose I could at least tolerate, if not enjoy, the game except for two unfortunate factors, the economics and the dangers of this All-American game.

The Foolishness

Football is an out-of-control economic monster. It is a major driving power of the gambling industry and a serious revenue source for our so-called institutions of higher learning. Gambling aside, let’s look into what it has done within colleges and universities.

In brief, it owns them. Because of this, it uses the school’s name, but is not subject to any real control by the rules and regulations that govern the school. The athletic department does not have a faculty and student structure like the school does.

The athletic department is not subject to the economic restrictions the school faces. The athletic department has coaches, not teachers, and athletes, not students. In our major universities, the head coach is more a warden for thugs than a teacher who is guiding young minds to reach their highest level. If you look at the statistics for crimes, both misdemeanor and felonies, such as sexual assault by “student athletes,” you will be shocked.

College football pays its coaches absurdly high salaries. The highest-paid coaches earn between $2 million and $7 million per year, and this is increasing. This doesn’t include a wide variety of perks, which can double that amount.

Compare that to college faculty, who earn between $25,000 to $150,000 a year with few perks. The average college president earns south of $500,000. In fact, the highest-paid public employee in several states is a football coach.

The explanation for this foolishness seems to be a combination of the huge amount of money college athletics brings to the school, there not being a need to pay players deemed to be amateur student athletes, intercollegiate competition and pressure from alumni and fans. All the while, faculty wages are stagnated, college costs are rising along with the part-time teaching staff, and the burden of student loans in increasing.

Do you really think a winning football team benefits the educational mission of the school, attracts higher-quality students or allows the school to receive more funding for its academic programs?

The Frailty

People were not designed to withstand the tremendous impact forces of playing football. We are too frail. The rate of injuries is massive, close to 500,000 per year. It’s one thing to have a fist fight and completely another to be hit by helmets and shoulder pads traveling more than 20 miles an hour while you may be going just as fast in the opposite direction.

If you play football, it’s not a question of if you are going to be injured, just when and how serious it will be. Still, football has survived all of this until now because now we have identified chronic traumatic encephalopathy (CTE) in football players.

CTE is a serious degenerative brain disease found in people who have suffered repeated blows — ranging from severe to mild — to the head. It can only be confirmed by autopsy after death. It seems the impacts of hundreds of supposedly minor blows can have the cumulative effect of many concussions.

In a recent study, Boston University researchers found evidence of CTE in 110 of 111 brains of deceased NFL players, and of 53 college players, 48 had CTE.

The neurodegenerative signs and symptoms of CTE takes around eight to ten years to become noticeable. Because of the huge amount of players involved in football for the past 20 years, many starting in their early teens have been exposed to these repetitive head injuries. I think we have only seen the tip of this CTE iceberg.

Ultimately, all of us will have to ask ourselves whether the benefits of football are worth the risk of damaged brains later in life. I certainly would not allow a child of mine to play this game.

Though I might tell them to be a football coach! Just kidding.

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

I’ll Drink to That

Crystal Geyser is a brand of bottled water headquartered in the wine country town of Calistoga, and I should have bought stock in the company years ago, given that my wife Gloria knocks back enough to fill a small aquarium roughly every three days. She is in tremendous physical shape, lean and fit and toned, and with not much more body fat than a bell pepper. I had always attributed that to the fact that about 70 percent of her daily food intake consists of salads, and that she swims for a hour each day and must be peeled like wallpaper from the Stairmaster (at her gym) and stationary bike (in our living room).

But according to researchers at the University of Illinois at Urbana-Champagne, the water may also be a factor.

At least, that’s the conclusion they reached after crunching data compiled on more than 18,000 adults by the National Health and Nutrition Examination Survey covering the period of 2005 to 2012.

The clickbait summation: increasing the amount of water you drink daily by a puny one percent reduces the amount of calories you consume. And yes, your initial assumption is correct: water drinkers, meaning those taking in one to three cups per day, tended to consume fewer sweetened beverages than average. But they also consumed fewer sweetened foods, as well as less total fats, saturated fats, sodium, cholesterol and sugars in general.

(Some) More Water = Fewer Calories Consumed

This across-the-board effect of water consumption is not exactly baffling: water takes up empty space in the stomach which, when unfilled, we experience as hunger. The less stomach space we fill with things more caloric than water, which is almost everything else, the fewer calories we take in. Specifically, approximately 68 fewer calories for every cup of water consumed.

Well, up to three cups at least; more than that and the effect seems to taper off markedly.

And the researchers are happy to add that the source of the water doesn’t matter; whether it’s from a spring or the tap, in a glass or a plastic bottle, from a water cooler or a drinking fountain, even out of the garden hose, the result is calorie reduction.

Among the recommended methods for increasing your intake of H2O:

Ask for water at restaurants, and knock back a half a glass or so before ordering.

Make a water bottle your companion, in order to have its hunger-slaking magic constantly at hand.

If you are an irredeemable sweetened-beverage drinker (sodas, energy drinks, fruit drinks, etc.), replacing just one eight-ounce serving per day with water equals 96 fewer calories, a heck of a deal.

However, one personal dubious note. While I am certainly in no position nor remotely qualified to question the researchers’ findings, I am somewhat troubled by the fact that the stunning growth in the consumption of bottled water—a commodity that barely existed in American homes and on supermarket shelves a generation ago and now is literally ubiquitous—has occurred over roughly the same timespan as the rise in overweight and obesity nationwide.

The water-equals-weight-control premise may work on an individual level, but someone needs to explain why it hasn’t been reflected the overall population.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

The vast majority of people get depressed at some point in their lives. It is not a pleasant experience. I was depressed when I went to medical school. One of the faculty told me that you don’t go to medical school to treat depression.

He was a surgeon. They do a lot, but they don’t know everything. Case in point, because medical school was very good for my depression. I’ll get back to that later. More to the present point, I can’t tell you how to treat depression. That is the purview of therapists and psychiatrists. What I can offer is a suggestion on how to cope with it by leaning into it, experiencing it and learning from it.

I saw a large, comprehensive three-part study, “The Psychological Health Benefits of Accepting Negative Emotions and Thoughts: Laboratory, Diary, and Longitudinal Evidence,” recently published in the Journal of Personality and Social Psychology. It found that people who tend to habitually accept their negative emotions and thoughts without judging them minimize their reactions to these emotions, and doing so does not lead to an unnecessary increase and prolongation in their mental suffering.

Led by Brett Ford, Ph.D, assistant professor of psychology at the University of Toronto, Canada, the studies looked at more than 1,300 individuals to determine how acceptance rather than denial of negative emotions often associated with depression, such as sadness, disappointment and anger, would affect their psychological health.

Avoiding Feelings Causes More Problems

The first part involved 1,003 subjects. They all completed a survey rating how strongly they agreed with certain statements, for example “I tell myself I shouldn’t be feeling the way that I’m feeling.”

The researchers found that participants who had more disagreement with such statements as these, which they felt indicated a greater acceptance of negative feelings, showed higher levels of psychological well-being, compared with subjects who attempted to resist these negative feelings.

In the second part, which had 156 participants, the subjects were asked to record a three-minute speech as part of a mock job application. They were told this would be shown to a panel of judges. The subjects were given two minutes to prepare their speech, and they were instructed to promote their relevant personal skills. After the recording was complete, the subjects were asked to report how they felt about the task.

The authors found that participants who tried to avoid feeling negatively about the task were more likely to experience distress, compared with subjects who embraced any negative feelings.

The third part involved 222 participants. Each subject was asked to keep a journal for two weeks to record any bad experiences they had and the emotions that they felt in response to such experiences. All the participants received a psychological assessment after six months.

The researchers found that subjects who tried to avoid negative emotions in response to their bad experiences were more likely to have symptoms of mood disorders, such as anxiety and depression, at the assessment compared with those who embraced their negative emotions.

Professor Ford says:

“It turns out that how we approach our own negative emotional reactions is really important for our overall well-being. People who accept these emotions without judging or trying to change them are able to cope with their stress more successfully.”

Discussion

The first study part verified that habitually accepting mental experiences broadly predicted psychological health measured by psychological well-being, life satisfaction and depressive and anxiety symptoms. The second part, a laboratory study, demonstrated that habitual acceptance predicted lower negative, but not positive, emotional responses to a standardized stressor. Finally, in the longitudinally designed third part, acceptance predicted lower negative, but not positive, emotion experienced during daily stressors that, in turn, accounted for the link between acceptance and psychological health six months later.

This link between acceptance and psychological health was unique to accepting mental experiences, whereas this was not observed for accepting situations. Overall, these results suggest that individuals who accept rather than judge their mental experiences may attain better psychological health, in part because acceptance helps them experience fewer negative emotions in response to the ongoing stress of life.

Better Not to Suffer Alone

I was visiting a psychologist friend at the hospital. Sitting at his desk I asked him why he had a roll of toilet paper on his desk. He told me it’s for people who cry. I don’t know if that’s funny or sad. Of course, we are going to suffer. That’s why we call it depression; otherwise, we would have called it elation. The important thing is that we need to accept, or as I say, lean into our feelings. Perhaps it’s a way our brains heal best from psychological injury. Trying to escape these feelings does not help us in the long run. We must experience them so as not to prolong the process. Having an accepting attitude toward our negative emotions gives them less power over us, while constantly judging our emotions seems to increase their power.

In the end, if there is a gift in being depressed, it is the learning about ourselves that can come as we improve and move through the misery.

As for being depressed before medical school, let’s face it, medical school has depressed plenty of students. So I figured, a depressive episode is usually over in six months anyway, and as long as I’m already depressed, I could suffer alone with that or go to medical school. There, I would be very busy and occupied and probably depressed anyway, but when it was over, I would no longer be depressed, and I’d have an M.D. to boot!

Adversity is the state in which man becomes most easily acquainted with himself, being especially free of admirers then.

— John Wooden

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Think of Eggnog as the Pecan Pie of Beverages

We are just a week away from Labor Day, which means we are entering a five-month period in which a number of celebratory calendar dates occur. Labor Day is, of course, the last big holiday of the summer in which eating and drinking will play a serious part, ranging from backyard beer-and-BBQ parties to lavish group picnics, extended family gatherings and traditional community celebrations.

After Labor Day comes the gauntlet that your waistline must traverse between now and Super Bowl Sunday: Halloween, Thanksgiving and December, with its inevitable minefield of fun times.

You will most likely try your best to watch what and how much you eat. But how much concern will you have for what and how much you drink? Mmmm…maybe not so much.

And yet your consumption of recreational libations, specifically those of the alcoholic variety, could easily be the single greatest contributor to your overall calorie intake. How many calories might we be talking about, you ask? That’s the problem. The main obstacle to limiting your alcohol-based calories is knowing how many calories your beverage of choice delivers. Which for some beverages can be harder than accessing Trump’s tax returns.

Calories in Alcohol are Anybody’s Guess

Consider wine, for example. The amount of calories in a standard glass can range from 100 to 200 or more, and that’s assuming your class is standard, i.e. five ounces. If it’s in a plastic picnic cup, all bets are off. The numbers are similar in the case of beer: a 12 ounce can can deliver anywhere from 55 calories to four times that amount, the equivalent of a side order of fries. Well, you might now ask, can’t I just look at the calorie content listing on the label? No. You can’t.

There are no Nutrition Facts provided on nearly all beers and wines. That’s because that information is required for food items, as regulated by the Food and Drug Administration or the Department of Agriculture. But alcohol products are regulated by the Treasury Department through its Alcohol, Tobacco and Firearms Division, and if you thought the AFT was lenient in controlling guns, the agency is virtually AWOL when it comes to booze. With few exceptions, it’s no Nutrition Facts required.

That will probably change in the case of beer; a non-binding rule proposed in 2016 by the Beer Institute to provide nutritional info on cans and bottles has been agreed to by the brewing biggies—Anheuser-Busch, MillerCoors, Heineken and their ilk—but the switch will be gradual, well into the year 2020. And even then, a whole host of imported and craft brews may not join the informational movement. Lacking nutritional info, you can only estimate your particular beer’s calorie count by doing some serious math involving the alcohol content, which is noted on the can or bottle—but that’s probably not how you prefer to pass the time at social events.

Let’s take two examples from my fridge, wherein sit a bottle of Guinness extra stout, alcohol proportion 5.6 percent, and a bottle of Mendocino Hawkeye imperial ale, 8 percent alcohol. Since 100 percent alcohol contains about 8 calories per gram, or 225 calories per ounce, the stout thus delivers 12.5 calories per ounce and the ale 18. If that’s not tricky enough, the Mendocino bottle is a regular 12-ouncer while the Guinness bottle is just 11.5 ounces. So, knock back a bottle of the ale and you’ve consumed 216 calories, whereas a bottle of the stout delivers a mere 144.

Mixed Drinks are Even Harder to Calculate

Faced with these calculations, a lot of drinkers would prefer to just switch to gin and tonic.

Of course, in the case of hard liquor, calorie calculation becomes almost laughably torturous. Depending on distillation, an ounce of pure alcohol may contain from around 160 to just under 200 calories. The calories in any given cocktail depend on the liquor involved—from around 65 calories per ounce in vodkas and tequilas at the low end to 100 or more in scotches—as well as the proof, which ranges from 80 to over 100, plus the non-alcoholic ingredients if any. A standard bourbon and Coke equals a tidy 195 calories, for example, and that’s if it’s a Diet Coke.

So, what’s a holiday drinker to do in the name of calorie control? Given the fact that the average American adult takes in about 100 calories per day through alcoholic beverages even on non-holidays, and that those calories are equal to roughly ten pounds of added weight per year, you may want to jot down the following well-meant suggestions for reining in your liquid calories on those special occasions.

Pretend you’re the designated driver. Or at least, drink as if a state police car was parked outside just waiting for you to head on home. On a more serious level, be aware that alcohol has a notorious disinhibiting effect, meaning the more you consume, the more likely you are to keep on consuming. Put a limit on yourself that you can hold to, and hold to it.

Stick with beer and other low-alcohol-density options. The less alcohol per ounce, the fewer calories you’ll consume for any given volume of liquid. That means eschewing the “stiff drink” based on distilled spirits.

If you do consume hard liquor, accompany it with ice, water or seltzer. Avoid mixed drinks involving sugars, creams and other caloric additives; a simple four-ounce White Russian, for example, packs the equivalent of a double cheeseburger: 400 calories.

There are two categories of alcoholic beverages that are obliged to post Nutrition Facts: the ATF requires beers and wines that label themselves as low-calorie or light (or lite) to back it up with posted calorie amounts on the can or bottle, and the FDA requires the same of wine-based beverages with less than 7 percent alcohol, such as wine coolers.

There are obviously a number of reasons to limit your alcohol intake at holiday events that have nothing to do with calories, ranging from collisions or physical arrest and resulting insurance rate hikes to long-term heart health. Use whichever spooks you the most as your motivator.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

For the past several years the concept of metabolically healthy obesity has implied that, in the absence of metabolic dysfunction, individuals with excess fat are not at greater risk for cardiovascular disease. The term “metabolically healthy obesity” refers to people with a higher-than-normal body mass index but no identifiable health issues.

This concept has been considered valid by health professionals and lauded by individuals with the Health at Every Size agenda. Well, thanks to a recent large and comprehensive pan-European study, we can put that foolishness to bed!

The Study

“Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis,” was published August 14, 2017, in the European Heart Journal. The study, done by researchers from Imperial College London and the University of Cambridge, in the United Kingdom, found that overweight and obese people, who have until now been considered healthy and treated as such, are actually at a significantly increased risk of developing coronary heart disease.

Using data collected by the European Prospective Investigation into Cancer and Nutrition branch of the World Health Organization, the study looked at almost 520,000 people, 366,521 women and 153,457 men, aged 35 to 70 years from 10 different countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden and the U.K).

All the participants were followed-up for a median period of 12.2 years, during which time 7,637 cases of coronary heart disease were recorded.

Individuals were considered metabolically unhealthy if they exhibited three or more metabolic factors, including high blood sugar, high blood pressure, abnormal triglyceride
levels, low levels of HDL or a larger-than-normal waist size, defined as larger than 37 inches for men, and larger than 31.5 inches for women.

The participants’ health status was compared against that of a control group of more than 10,000 metabolically healthy individuals. The data was controlled for factors such as smoking, dietary habits, physical exercise patterns and socioeconomic status.

The study results found that participants who fell into the metabolically unhealthy category, regardless of whether they had a normal weight, were overweight or were obese, had more than twice the risk of developing coronary heart disease than those that had two or fewer metabolic factors.

This was not surprising. However, when the study looked at the metabolically healthy individuals who were overweight or obese, they had a higher risk of developing coronary heart disease compared to those of normal weight. Participants classed as overweight but metabolically healthy had a 26 percent higher risk of coronary heart disease than their normal weight counterparts, and metabolically healthy obese participants had a 28 percent higher risk of coronary heart disease.

According to Dr. Ioanna Tzoulaki, one of the study leaders:

“I think there is no longer this concept of healthy obese. If anything, our study shows that people with excess weight who might be classed as ‘healthy’ haven’t yet developed an unhealthy metabolic profile. That comes later in the timeline, then they have an event, such as a heart attack.”

Discussion

Presently, in the United States, more than two in three adults, as well as around one third of all children and teenagers, are overweight or obese, and this number is not improving.

The economic and resource ramifications of this study are obvious. Individuals with metabolically healthy obesity are at risk and are not being treated as such. Because of this, when the statistics play out and these people do have their serious event, the health care system and our economy will bear a burden that it is presently unprepared to handle.

The researchers feel that taking steps to counteract excess weight and obesity, regardless of how healthy a person may appear to be, is crucial to preventing heart disease and its effects on society:

“Our findings suggest that if a patient is overweight or obese, all efforts should be made to help them get back to a healthy weight, regardless of other factors. Even if their blood pressure, blood sugar, and cholesterol appear within the normal range, excess weight is still a risk factor.”

Conclusion

No matter what your BMI, if you are metabolically unhealthy, you have a higher coronary heart disease (CHD) risk than if you are not. If you are overweight or obese, regardless of your present health, you have a significantly higher risk of having CHD.

It is important to address coronary heart disease in individuals in as preventive a way as possible. These individuals have to be identified and treated for the risks they have. If they are not, they will just show up at the ER one day due to a cardiovascular event.

This will increasingly tax the resources of the healthcare system and be a burden on the economy. The good news is that obesity is treatable, unlike many forms of cancer and other incurable diseases.

We need individual and population-wide strategies to tackle the issue of being overweight or obese. Therein lies our challenge for the future!

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Probably Not, But I Couldn’t Pass Up the Opportunity to Use that Pun

Last week I posted about anxiety in the corner offices in the diet industry due to overweight or obese Americans increasingly rejecting the notion of dieting. Ironically, there’s an equally anxious knot of executives at the other end of the dietary health spectrum: breakfast cereal manufacturers. Sales of cold and hot cereals fell by 17 percent from 2009 to 2016, from $12.2 billion down to $10.6 billion, and are expected to sag even further in the near future. Cereals owned 27 percent of the breakfast market five years ago; it’s down to 22 percent now.

And wouldn’t you know who the cereal folks blame for this—those darn Millennials. They’re just not shoveling down the breakfast cereals the way they should be, which would be more than any other consumer group. Instead, I’m embarrassed to report that the mainstay demographic for cereal consumption is my own, the Boomers; fully 23 percent of us breakfast on packaged cereals, compared to just 17 percent of Millennials.

The problem for Big Cereal is that the Boomer cohort is dwindling, and at an accelerating rate, with the M’s having passed us to become the largest age bloc. (Which raises, at least for me, the question of how apt the name Boomers still is, since we no longer boom but increasingly cough, wheeze, mumble and grunt; but I digress.) How to invigorate the desire for cereals in more Americans aged 18 to 34 or so is thus the current focus of cereal makers’ attention. Their approaches to the challenge, and the implications for the American diet, are both promising and discouraging.

Cereal Isn’t Convenient Enough

The industry thinks it knows why gen-M isn’t sitting down to a big bowl of processed carbs like previous generations: it’s a matter of nutrition, which isn’t surprising, and convenience, which sort of is. According to consumer research, M’s are the point generation in a growing overall consumer preference for foods rich in nutrients, protein, fiber and natural ingredients. Thus it has been goodbye Count Chocula and Sugar Crisp, and hello yogurt, fresh fruit, protein-packed breakfast bars and even fast food egg/cheese/sausage muffins. That’s the positive part.

The promising news is that Kellogg and General Foods, which together account for nearly half of all cold cereal sales, are trying to actually health up their products, shifting to whole grains and cutting down on the sugar, sodium, carbs and artificial flavors and colors; in some cases even shifting to fruit flavorings derived from actual fruit.

But then there’s the matter of convenience, which was originally and for many years one of the main selling points of breakfast cereal: it was quick and easy. Pour some in a bowl, add milk, there you go. Alas, that’s not how Millennials, who tend to lead life on a dead run, see it. To them, it’s a veritable ordeal: pour it in a bowl, get some milk from the fridge and add it, and there you sit, for however long it takes to eat the stuff, and then you’ve got to clean up when you’re done! Mind you, I’m not being sarcastic: a survey of M’s in 2015 found that just under 40 percent of them consider cereal to be inconvenient because you have to wash the bowl afterward.

It’s Not Just for Breakfast Anymore

And this has led them to the same breakfast alternatives as above, the kind you can eat in the car or walking to the bus stop or otherwise consume on the go: fruit, yogurt, nutrition bars, muffin breakfasts, stuff you can chow down while texting. To the extent that these food items have reduced our morning consumption of high-carb, highly-sweetened, high-calorie choices of the Frosted Flakes and Lucky Charms variety, fine and dandy. But the cereal sellers have responded to the convenience issue by promoting their products as perhaps not super-convenient for breakfast but very much so the rest of the day and evening.

According to the director of Kellogg’s Froot Loops division, who must have a business card for the ages, his cereal and others like it should be considered as “an awesome snack.” You can keep a box handy just about anywhere and munch it by the handful. It’s quick, easy, and thanks to preservatives, will last longer than most Millennials. And it’s a perfect fit for that generation; a greater proportion of M’s already eat cereal at other times in the day, including for dinner, than do consumers in general.

Kellogg’s is already ginning up its first new marketing blitz in decades, promoting the not-just-for-breakfast-any-more concept with an ad campaign whose tag line is “Whatever Froots Your Loops,” a slogan that is evidently aimed at the subgroup of Millennials whose IQ is roughly that of a horseshoe.

Hopefully, it won’t fly, and consumers won’t wind up eating just as much sugary processed cereal, only later in the day. At the least, calling these products a snack food and marketing them as such is certainly more honest than implying that they’re an essential part of a balanced breakfast, given that based on sugar content and general nutrition most of them should be stocked in the supermarket candy aisles.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

I recently saw this humorous, yet amazingly accurate warning sign! (The photo is from a bed and breakfast in Wisconsin that was damaged in a fire, and was posted on reddit in 2015 by user Kiwifish5, who took the photo.) It’s hard to explain why we have serious warnings on some things and not on others.

Ladders, for example, probably have 20 warnings on them, yet the numbers for serious ladder events pale compared to an unhealthy lifestyle of poor eating and little activity, yet we don’t have a warning posted on unhealthy foods. Even with cigarettes, we have had to have a small war with our legislature and legal system in order to have minor warnings on the packages, while proven, effective photographic warnings won’t be allowed.

Don’t you sometimes wish everything had an accurate warning sign on it? Of course, it might be really nice if there was the other extreme where honest, encouraging signs were on things telling us how entering that area was really good for us.

Unhealthy Choices Will be Hazardous to Your Health

I’ve been writing the “Dr. J Will See You Now” column for close to ten years. During that time, the other CalorieLab writers and I have done our best to bring you both the important warnings and encouraging, useful information that would assist you with your wellness journey. No, we haven’t gone to the extremes of a warning sign, CalorieLab Exhibit 1, such as:

“Please do not enter the dangerous areas of unhealthy eating and lack of exercise. You quite possibly will get very sick and die much younger with a lot of suffering. This will happen after a protracted time of extensive medical treatment that will exhaust you and your families financial resources.”

We have tried to educate you on the dangerous areas of unhealthy eating and lack of exercise using scientific presentations and research studies as well as anecdotal material from our own experiences. I think we have made a valid case for the multitude of disease morbidity and mortality that awaits anyone who foolishly ventures beyond that gate. We have also shown, as well, how a healthy active lifestyle vastly improves your odds of having a productive and fulfilling life.

Our greatest hope is that when you are living a long and healthy life, you will think of CalorieLab as that type of honest encouraging Exhibit 1!

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Or If Not Actually Dirty, at Least No Longer Marketable

According to the New York Times, the weight-loss industry is having a mild panic attack these days. Although nearly 70 percent of adult Americans are overweight or obese, they are increasingly less inclined to go on a diet.

That’s not to say that they don’t want to lose weight, just that they’re giving up on the traditional idea of dieting. These days, they prefer to talk about eating “strong” or “clean” or “healthy” or “living fit.”

And you can’t really blame them for abandoning their faith in the diet concept. They’ve seen the study results, which consistently show that the vast majority of dieters actually don’t lose much weight—even Weight Watchers research found that on average dieters shed just about five percent of their weight over six months—and usually regain one-third or more of the lost weight in two years.

And they’re aware of studies suggesting that each human body sets its own ideal weight based on genetics and metabolism, and good luck trying to get it to stay leaner than it wants to over the long haul.

Diet is a Four-Letter Word

Overweight Americans still want to eat healthier food and be active and embrace a fit-and-trim lifestyle. They just don’t want to use the D-word to describe it. Naturally, this has produced some nervousness in diet industry executive suites.

Lean Cuisine, for example, has all but expunged “diet” from its website and now describes itself as being in the “modern eating” business. Weight Watchers, whose very name is a synonym for “dieters,” is even more uneasy about the new wave of diet deserters, and is looking to rebrand itself as a “behavior modification” company.

The current working theory in the Big Diet boardrooms appears to be that the way to get people to diet or otherwise enter a weight-loss program is to come up with self-descriptions that replace the words “diet” or “weight-loss,” and to even be cautious about throwing around the word “program.” Coming up with successful or even promising diet euphemisms will take some ingenuity and finesse. Given the target audience—people oriented toward self-improvement—the new labels would have to neatly fit into the sentence, “I’ve gotten seriously into (blank) lately, and it could be a life-changer.”

With that in mind, here are a few suggested alternatives to “dieting” or “weight loss.”

Body Sculpting. “Sculpting” has a sophisticated, even artistic ring to it, and appeals to the average person’s narcissistic conviction that he or she is basically a Greek statue trapped in the body of a bus driver. That’s how Greek statues are created, after all: you start with a large shapeless mass and whittle or chip or grind away at it until what’s left could pass for an Olympic swimmer.

And let’s face it: the fundamental motivator in any weight-reduction effort is the notion, politically incorrect or not, that less fat equals more physically attractive. My guess is that for every person who undertakes to lose weight for health reasons, there are a half dozen who do so to make looking in the mirror more appealing than appalling.

Physioforming. I’ve adapted this from the word “terraforming,” a sci-fi term that means technologically and physically transforming an entire alien planet so that it becomes similar enough to the earth that it is habitable for human beings.

In a sense, that’s an apt analogy, since the goal is to have a body you are more able to live with. The “physio” part also conveys a coolly biotech image, which would particularly appeal to the hefty hipsters among us. Frankly, I’m surprised some weight-loss entrepreneur hasn’t already copyrighted the term; it fairly cries out to be part of a book title in the Self-improvement section.

Shape Shifting. Attention Weight Watchers execs: Shape Shifters could be exactly the new name you’ve reportedly been seeking. It implies a kind of Marvel Comic-y empowerment in reverse, wherein the idea is to change from an incredible hulk into someone of normal size and shape.

It would certainly attract the interest of those legions of Millennials who would dearly love to attend a ComicCon if only they were able to fit into the costume of their particular totemic superhero.

Metabolic Resetting. This really gets down to the core issue, which is that dieting and exercise are often fruitless if your body continues to work to maintain what it has decided is your appropriate weight. The goal is not to battle your metabolic rate, but to fundamentally alter it to seek a reduced “proper” weight setting.

The troublesome drawback to this goal is that we have no idea how to actually achieve it. On the more positive side, no other weight-reduction program or philosophy does, either. Good luck.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

It seems that the general public’s opinion on the use and availability of marijuana is changing. Currently, there are laws in many states allowing for its use in various forms for a variety of issues.

As a doctor, I think this is a good thing because there are several medical problems where marijuana seems to have the potential to be of benefit, and I’m glad that these needy individuals have more access to a drug that can help them.

Unfortunately, because of the stigma attached to the drug, there has been a paucity of thorough scientific research, as most of the data about marijuana use is more subjectively empirical than objectively scientific.

Now however, because of these changing opinions and laws, we can subject marijuana and its derivatives to more rigorous scientific testing and have a better idea of exactly what medical problems can be successfully treated with this relatively benign drug. One of these areas is its use in the treatment of stress. A recent study looked at the use of marijuana and its effects on stress and found that its chronic use will significantly decrease the user’s response to stress!

The Study

“Blunted Stress Reactivity in Chronic Cannabis Users,” is published in the August 2017 issue of the journal Psychopharmacology. Led by Carrie Cuttler, PhD, a clinical assistant professor of psychology at Washington State University, the study compared the effects of acute stress by measuring the levels of the stress hormone cortisol in the saliva of long-time marijuana users to that in non-users.

The researchers easily recruited 40 chronic marijuana users, defined as having used marijuana every day or nearly every day during the past 12 months. They managed to find 42 non-users, defined as not having used marijuana more than 10 times ever, or not having used it at all in the past 12 months.

All subjects gave urine samples to confirm their usage status. The subjects were randomly divided into who would complete the cruel and unusual version or the no worries version of the Maastricht Acute Stress Test. Prior to being tested, all of the subjects were told not to use marijuana on the day of the test. Forty-two remembered being told.

The test consisted of physiological and a psychosocial stressors. For the physiological stressor, subjects placed a hand in ice-cold water for up to 90 seconds. In the no-stress condition, the participants put their hand in lukewarm water.

For the psychosocial stress condition, the test got serious, having participants count backward from 2,043 in steps of 17, all the while watching themselves on a video screen and being subjected to negative verbal assaults when they made arithmetic mistakes, of which there were plenty.

The no-stress group was just asked to count from 1 to 25 in steps of 1.

The researchers measured cortisol levels from saliva samples that the participants gave before and afterward. Additionally, the participants were asked to rate their stress levels before, during and after the stress test.

Results

The subjective stress ratings and cortisol levels were significantly higher in non-users in the stress condition relative to non-users in the no-stress condition.

Marijuana users, however, demonstrated diminished stress reactivity, as they showed no increase in cortisol in either stress situation and only a very small increase in the self-reported stress ratings.

They did exhibit a bit of stress after the tests, however, when they were told there would be no available chocolate chip cookies.

Discussion

The researchers suggest that using marijuana may increase resilience to stress, particularly in people who have a heightened emotional response under stress. They also feel that future research is needed to determine whether this helps to confer resiliency or allows more vulnerability to stress-related situations.

Professor Cuttler added that the work is not encompassing enough to show whether the apparent dampened stress response in long-term marijuana users is a good or a bad thing. However, she does feel that it is “an important first step in investigating potential therapeutic benefits of cannabis [marijuana] at a time when its use is spreading faster than ever before.”

It seems this team has an active interest in furthering scientific knowledge in the area of marijuana research. Washington State University has added this information to their recruiting adverts.

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Good News, Not-so-good News and Surprises

There have been few distinct trends in our consumption of most broad food categories from 2003 to the present, with virtually no change in the percentages of Americans who either actively avoid or actively include poultry, dairy products, seafood, fruits and vegetables in their diets. But in a few cases we have clearly migrated in the direction of healthier.

According to a Gallup survey of food choices then versus now, we have apparently wised up about the downsides of sugar, as those who avoid it have increased from 43 to 50 percent. It’s even better in the case of soft drinks: includers have shrunk from 36 to 22 percent and deliberate avoiders have soared from 41 to 62 percent.

On the other hand, there has been a modest three percent shift from avoidance to inclusion for red meat, which has been found to be associated with several health problems.

That might be one element in a significant shift in our consumption of fat, which fewer of us now avoid, down from 62 to 47 percent, and more of us actively include, up from 16 to 25 percent. Not coincidentally, a number of studies over that time have found that many health problems formerly blamed on fat are more accurately linked to carbohydrates, and indeed, there has been a six percent shift from inclusion to avoidance of carbs.

A lot of this reflects our growing rejection of sugary foods and beverages, but we’ve also become less infatuated with grains (bread pasta, cereal), with avoiders having risen from 6 to 14 percent and includers fallen from 81 to 70 percent. How much of this modest shift is attributable to gluten phobia, I don’t know. And finally, we’re cutting back on salt, with a 7 percent shift from inclusion to avoidance.

America Still a Fast Food Nation

When it comes to fast food, Gallup finds that since 2003, our visitation rate has changed very little. A resounding 80 percent of us report that we eat at a fast-food restaurant at least once a month, compared to 82 percent 14 years ago, but the percentage dining there once a week or is down by a slightly more encouraging five points, from 52 percent to 47.

Alas, only four percent of us never eat fast food at all, down from five percent in 2003. This surprised me, because I haven’t eaten anything from a fast-food restaurant in years, and I don’t think of myself as being an outlier, American lifestyle-wise. I would have assumed myself to be part of a discernibly larger demo, 10 percent at least.

If we continue to patronize fast food outlets pretty much as often as we did in 2003, it’s probably because our opinion of fast food hasn’t changed much. What’s eye-catching is that we continue to consume fast food despite our opinion of it. Fully 76 percent of us says it’s either “not too good” or “not good at all for you” today, and the exact same percentage said so 14 years ago. And yet nearly half of us eat the stuff once a week or more.

Of course, that turns out to vary significantly by age group. With age comes, if not wisdom, at least increased concern with our health, which may explain why the portion of adults who eat fast food at least once a week declined from 57 percent among the 18-29 demo to 41 percent for those over 65.

Gallup also found that 53 percent of men eat fast food at least weekly compared to just 42 percent of women, and that, broken down by race and ethnicity, the percentages are 53 for Hispanics, 52 for African Americans, and 46 for non-Hispanic whites. The most unexpected statistic has to do with annual income. It also says something about our—or at least my— racial and ethnic stereotypes.

Because blacks and Hispanics are overly represented among low-income earners in the United States, that income group presumably eats the most fast food, right? Ha! Shows how much you and I know.

It turns out that almost everybody eats more fast food than low-earners. Specifically, in each of the top three earning groups—$30,000 to $50,000; $50,000 to $75,000; and $75,000 or more—51 percent eat fast food at least weekly, while for those bringing in $20,000 to $30,000 the number is just 42 percent, and for those earning even less, it’s a mere 39 percent. At that economic level, even your Taco Bells and Burger Kings may be unaffordable.

Or perhaps there’s just no association between income and common sense. See cable TV news channels for further evidence.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

Did you know that there are connections between losing weight and saving money? It’s very common for people who have problems with their weight to also have issues with money. Perhaps this is because losing weight and saving money are, at their simplest, both math problems.

To lose weight, you need to create a calorie deficit by eating fewer calories than what your body needs to be at its current weight, and to save money, you need to spend fewer dollars than you earn. The math becomes dollars in versus dollars out, and calories in versus calories out.

Unfortunately, writing a formula on the wall and then translating it into action in real life is not easy. Of course, most people understand that eating unhealthily and not getting very much activity will lead to weight gain, just as plenty of people understand that if you spend more than you make, you will run into debt. Most likely, an overweight person and a poor person understand this better than anyone else.

However, anyone who as ever tried to lose weight or save money knows it’s one thing to understand the math, and it’s another thing to make the life decisions that will allow you to achieve the desired results. You see, when it comes to weight loss or money gain, in can be helpful if we have the perspective that we are investing for our future, because health is wealth, and wealth can usually help us have better health!

Step One: Open an Account

Here is where you have to do your initial research to find the plan that is right for you and the goal that you want to reach. It’s about educating yourself and understanding the numbers, usually in calories or portions.

You want a sustainable way of eating. Remember, we all tend to underestimate the calories in our foods and overestimate the calories burned through exercise.

Don’t make the mistake of thinking that you can rely on sheer willpower. Willpower is a limited resource. In fact, when we expend willpower on certain things, our other goals often tend to diminish. That means if you are trying hard to save money, you not be as focused on eating healthy.

That’s why it’s helpful to figure out a system that will help you make the right decisions without using your limited reservoir of willpower.

When it comes to saving, it’s consistently putting aside a reasonable amount every month. When it comes to losing weight, use a concrete consistent plan, such as preparing the items you need in the morning the night before, stocking your fridge with healthy foods, getting the unhealthy ones out of sight or better, out of the house, and not going out to eat if you can’t handle that yet.

Step Two: Fund Your Account

Consider the calorie loss amount needed to achieve your goal or the amount of money you must save per week. Your loss in this case is really your gain.

Remember, you can’t out-train a bad diet, and you can’t out-earn bad spending. Sure, eventually cutting a high amount of calories or making a large income can be very helpful, but what will be more important is planning for the long term, and not foolishly ruining it with indiscriminate spending or eating.

Step Three: Invest the Money

Decide on what is the best plan for you. Just saying that you are going to lose weight will not work all by itself. You need a concrete accountable plan and specific goals and steps. You have to make your new lifestyle a habit.

Choose your plan based on your risk tolerance. Risk tolerance is the degree of variability in investment returns or loses that an investor is willing to withstand. You should have a realistic understanding of your ability and willingness to tolerate large swings in the value of your investments, just as you need to have a lifestyle that is sustainable and workable for your needs and limitations.

Compound interest and continual vigilance of your eating habits can be your best friends.

Step Four: Keep Track of theNumbers

If you want to lose weight, you need to measure what you are eating. If you want to save money, you need to measure how much you are spending. Trying to lose weight and save money means that you are, by definition, making a change in your lifestyle in order to see results.

Your current diet and/or spending isn’t working, obviously, or you would have already gotten the results that you wanted. Keep a journal or other record of what you are eating, or what you are spending. This will reveal what is really going on.

You cannot just guess or think it’s all right. You will, most likely, not be successful if you think you can do it that way.

Step Five: Automatic Investing

Once you are set up and have done your plan and it has become a habit you can just work the plan for a while. Know that you have done well. You are in the be happy where you are but continue to strive to be better stage. Just remain vigilant

Step Six: Review Your Progress and Goals

You will need to periodically review your plan as you and your life change. If you need to lose a large amount of weight, you will need to make changes to your plan because as you successfully lose weight, you calorie needs also change and you need to allow for that or you will plateau and become discouraged.

Also, you may find that your plan is working but you have the ability to work harder to get where you want to be because you feel better at a lower weight and can do more or with healthier eating you are motivated to eat even cleaner and you can increase your calorie deficient without sabotaging your accomplishment.

With money, there are always unforeseen expenses that may alter your savings rate, but know also there are positive monetary rewards that will come your way and be a benefit to you.

Step seven: Befriend Your New Lifestyle

Now that you are seeing the results of your efforts, you will confidently feel that it has all been worth it. Sadly, many people feel the safest place to be is the misery you know rather than the better unknown. You have beaten that trap, because you know the greatest similarity with losing weight and saving money is they are both very important investments for your future.

Congratulations, your future is here!

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Better to Chill Out than to Pig Out

The scorching days of late summer and early fall are breathing down our neck, and for a lot of us, have already arrived. And if you ordinarily have difficulty maintaining your weight, it will almost be a miracle if you can get through the Days of Heat without packing on some more poundage. There are a number of reasons for this, most of them fairly obvious but one or two a bit more subtle or even unexpected. How about a quick run-through?

The seductive allure of frosty and refreshing beverages will be all-but irresistible, and those beverages will very often involve alcohol (beer, wine coolers, etc.) or sugar (soft drinks, sports drinks, sweetened teas, etc.), both of which are just chock full of calories.

If it’s a terrible idea to go food shopping when you’re hungry, it’s not much smarter to do so when you’re baking from the heat wave. For one thing, you’ll be tempted to continue filling your cart with edibles and drinkables just to take advantage of the supermarket’s air conditioning. Even worse, you’ll be an easy mark for the frozen desserts aisle and may very well buy enough ice cream to build a small snowman.

Don’t expect to burn off anything close to your normal number of calories. The last thing you’re eager to do when the thermometer surges past 85 degrees is hit the gym, which is discouragingly hot and sweaty even in balmy weather, and forget jogging, tennis, basketball and any other form of physical exertion that cannot be done in a swimming pool.

For that matter, forget lap swims, unless you (a) have access to a private pool, or (b) consider threading your way through several hundred other heat-fleeing citizens to be exercise. Whatever your idea of a workout may be, it will be limited if not postponed altogether when the air above the sidewalk makes wavy lines.

Growing up in Southern California I became familiar with a phrase that was predictably a virtual mantra from early July to mid October: “It’s too damn hot to cook.” But the car had air conditioning, which meant it wasn’t too damn hot to cruise to the nearest golden arches or taco take-out or finger licking’ chicken outlet. Fast food may be fatty and oily and supersized and loaded with calories, but it beats working over a hot, or even warm, stove. And the combo meals invariably include a soda. But why even venture out into the heat when you can just have a triple cheese “meat lovers” party pizza delivered to your door?

Those are the obvious hot-weather hazards to those struggling to avoid weight gain, but according to an article by Katherine Milkman in the Washington Post, the heat also diminishes our ability to recognize and overcome those hazards. She refers to several studies, which together indicate that soaring temperatures tend to make us, in her phrase, “heat foolish,” due to a kind of numbing of the wits by the weather. For a lot of us, it can literally become “too hot to think straight.”

As the temperature soars, so does our inclination to make rash or ill-advised decisions and choices. It’s a one-two punch to your paunch: the body says “just lay on the couch eating Eskimo Pies,” and the mind says “sounds good to me.” And this is all made even more problematic by those two grim little words: climate change. As the days grow warmer and their number grows larger, the risk of falling into the grip of Fahrenheit foolishness increases as well.

But you’re not totally helpless. As Milkman points out, “The biggest thing you can do to help yourself may be recognizing the potential problem [and] remembering that the heat warps your judgment.” Avoid impulsive heat-beating measures. Instead of high-cal drinks go with good old ice water. Instead of frozen desserts, have plenty of fresh fruit at hand in the refrigerator. Take early morning or post-sunset walks or jogs. If it’s too hot to cook, take comfort in a nice big tuna or crab or shrimp salad.

And remember: this too shall pass.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

Have you thought about the relationship between truth and advertising? Do you feel the role of advertising is to tell the truth about the product or to make the product as attractive as possible so we will desire to obtain it?

If you are like most people, you probably feel that the purpose of advertising is to exaggerate a little and show the product in its best light, but you still assume that they can’t tell outright lies. If that is the case, then you would be wrong because, in fact, they do lie, and they have been legally allowed to do so!

Watch this commercial. There is a lie in this commercial. Can you spot the lie?

First let me give you some background information. I watched this commercial because my brother sent it to me saying that our mutual friend’s beautiful collie dog was starring in it. After watching it, I certainly saw the dog, but who were “Jessica and Riley,” the “actual Beneful consumers?”

That was our friend’s dog for sure, but the woman who was presented as the owner was not our friend. She was, in reality, a paid actress. Also, as far as I know, “Riley” is well-loved and isn’t fed this cheap dog food. Our friend did sign off her rights for this commercial, but when can you legally give someone else permission to lie? Actually, you can, because our courts have done this quite frequently.

Truth and Advertising Versus Idiot and Unreasonable

Telling the truth would seem to be, in theory, uncomplicated. Unfortunately, from an advertising point of view, the truth is not always attractive nor appealing enough to convince consumers. What advertisers then do is everything from adjusting the truth to telling such outrageous lies that our courts have decided that we would have to be idiotic to believe them, indicating that idiots are not entitled to the same protection under the law as non-idiots.

One example of this idiot-clause argument is when Coca-Cola was marketing their line of Vitaminwater by promising the stuff would “boost your immune system” and “help fight free radicals,” Coke responded that “No consumer could reasonably be misled into thinking that Vitaminwater is a healthy beverage.”

Another example was when Apple was advertising their iPhone 3G as, “Twice as fast. Half the price.” Apple’s legal defense was the same as Coke’s: “No reasonable person in the plaintiff’s position could have reasonably relied on or misunderstood Apple’s statements as claims of fact.”

Lies in the Supermarket

I would think being a savvy, health-conscious food shopper, that you pay a lot of attention to the ingredients and nutrition labels to see what the food you are buying is really made of. Sorry, there are lies there, too. No matter what the sugar, fat or sodium content of any given food appears to be, there is always one number that can completely change the appearance of everything: the serving size, and these are inconsistent and manipulated.

The value of the serving size allows the company to divide the amounts of each and every ingredient. Sure, all the information is still right there in the ingredients list, but you have to be some kind of mathematical savant to decrypt it all.

Even if you can figure that out, what about all the spurious health claims on the packaging? Foods or products claiming to reduce stress, make you lose weight, gum that whitens and cleans your teeth, gives you energy and kills bacteria — forgetaboutit! Personally, if they standardized all serving sizes to the same value and measuring system, that would go a long way to reducing my stress.

Another thing you see is how a food product is made to sound better for you than something else. Even junk food is healthy compared to something. Any food, no matter how unhealthy, can be advertised as low in one thing or high in another so it appears alright. I continually see “cholesterol free” on food items that, obviously, could never contain cholesterol, like salads.

Then there is the way advertising is aimed to make you perceive unhealthy items as healthy by the language that is used in presenting it. Words such as character, faith, belief, integrity, have been used to push beer of all things.

Discussion

According to the Oxford Dictionary, advertising is intended to persuade and sometimes to inform, and a huge purpose of advertising is to create desire in the consumer to buy the product. Advertisers must have some personal responsibility for their presentation. Yet in our free-market economy, it can be hard to make rules that are both honest and effective.

However, we need rules to prevent marketers from behaving in all sorts of contemptible ways and getting away with it. It’s no surprise that contract law has, as one of its foundational principles, caveat emptor, let the buyer beware.

However, you the buyer do have the final power. Your expectations and satisfaction are important. There are ways to voice your opinions on advertising content and products from social media through complaints to organizations and agencies whose mission is to monitor our media against misleading, damaging or offensive advertisements. Educate yourself, be skeptical, and pay attention.

By Dr. J, a maxillofacial surgeon living in Florida. Dr. J has travelled to Haiti to treat indigent patients and has taught as an associate professor at a Florida dental college. In his spare time Dr. J is a dedicated runner as well as a pilot who flies his Piper Cherokee Arrow throughout Florida. He has a black belt in karate. Dr. J has written for CalorieLab since 2007.

Abandon Hope, All Ye Who Enter the Food Court

A few years ago, I wrote an e-book titled “115 Reasons Why It’s Not Your Fault If You’re Fat.” There were 115 reasons not because that was all I could come up with, but because at some point I had to stop adding reasons in order to publish the book. Even after it was published, I continued to run across factors that could contribute to a person’s weight gain that were largely beyond that person’s control or which the person was unaware were thus contributing. If the book had been a best-seller, I probably would have taken a crack at a sequel by now, inasmuch as I’m pretty sure the number of fattening factors has since grown to 200-something.

Some of them are of the borderline goofy variety, some are uncommon or esoterically clinical, and some are sketchily researched but fascinating nonetheless. I just ran across one that falls into the latter category. It will seem obvious initially, but it’s more intriguing than it appears on its face.

It’s food aroma. Or more accurately, how your body responds to food aromas. And it’s a lot more involved than the obvious “Makes me want to eat.”

Smelling Food Makes Mice Fatter

This is based on research from UC Berkeley that studied three groups of lab mice: those with normal smelling ability, those with extremely heightened smelling ability and those unable to smell at all. All the mice were fed the same amount of the same food based on a high-fat diet designed to promote weight gain.

The normal smellers doubled their weight on the diet, but the super smellers got a whole lot fatter still, while the non-smellers, on the same diet, gained just 10 percent in weight. The ability to smell food in and of itself and independent of appetite was linked to a corresponding increase in weight.

Blocking Smell Helps Burn Fat

But wait, it gets even better. Using a toxin that temporarily wipes out the nose’s olfactory neurons, the researchers deadened the sense of smell in a group of obese mice. The fat mice began losing weight and continued to do so until they were down to normal mouse size—although they were still on the high-fat “Burger King” diet. And nearly all the lost weight was in the form of fat. As the researchers were quick to note, if this pattern can be duplicated in humans, it could seriously alter the entire approach to weight control.

And there are grounds for thinking it might be transferable. We know that odors and our ability to smell them effect human hormones that influence our fertility and sexuality, so why not hormones that influence our metabolism and fat-burning mechanisms? And we know that after we’ve eaten, our sense of smell declines. If the satiety-and-smell relationship goes both ways, decreasing our ability to smell might fake our body into feeling full and burning off calories rather than storing them.

How great this would be is still up for debate. If obese individuals unable to otherwise lose weight could do so by simply having their sense of smell temporarily eliminated or reduced and their metabolic fat-burning amped up, that would seem to be a much safer and less drastic option than stomach stapling or banding surgeries.

But there are still downsides. We are hardwired to derive satisfaction from eating, and persons who for various reasons lack the ability to smell are denied this pleasure, with clinical depression sometimes resulting. Another thing lost with the pleasure of eating is an unhealthy amount of weight among those who are no longer motivated to take in food. And the mice who lost their sense of smell experienced a spike in a particular stress hormone that at high levels can cause a heart attack; seriously not good.

Finally, there’s the fact that the deadening effect only lasts for three to eight weeks, which means that for weight-maintenance the olfactory neurons would have to be obliterated on a regular and recurring basis. The law of unintended consequences makes this prospect highly unsettling. How much toxin is too much and how many treatments are too many? Come to think of it, is there some reason that simply wearing nose plugs would not produce similar results? And do aromas of fattening foods (fries, pie, cheeseburgers) link to greater weight gain than fruit or vegetable smells?

Other questions arise, but in the opinion of one Berkeley researcher, “Even relatively short-term loss of smell improves metabolic health and weight loss,” and is thus worth investigating for human usage. Further research seems inevitable, so we will probably find out if the concept—and forgive me because I can’t help myself—ultimately passes the smell test.

By Robert S. Wieder, CalorieLab’s Senior Health Columnist since 2006. Author of several books, including 115 Reasons Why It’s Not Your Fault You’re Fat, Bob wrote for numerous national magazines after starting out as editor of the UC Berkeley humor magazine the California Pelican. He also put in a stint as a San Francisco-area stand-up comic.

Are you certified in CPR (cardiopulmonary resuscitation)? I saw a news story this week about a woman who holds CPR classes like they were Tupperware parties, except you are learning a skill that may save your child’s life. I think this is a wonderful idea!

I’ve never had to do CPR on a child, although I did do a month of anesthesia training at a children’s hospital so I got plenty of experience working with unconscious kids. When it comes to CPR, children are pretty similar to adults except the force required to do the job of compressing the chest and maintaining and ventilating the airway is much less for them.

I do have a lot of experience with doing CPR on adults, though only in a hospital or office setting. I have also gone to the ground for people who have had other medical emergencies out and about in order to stabilize and protect them.

CPR Over the Years

The history of CPR is quite interesting, and beyond the scope of this column. Suffice it to say that many less-than-successful methods were used over the years before the modern version of CPR was accepted in the late 1950s. I’m sure similar methods were done well before then, but these were never publicized nor had widespread acceptance. The numbers of people saved by this relatively easy technique must number into the countless millions.

When I began doing CPR, we were taught to do a strike to the mid-sternum (pre-cordial thump) to attempt to restart the heart, but that has since fallen out of favor. I once used this technique on a dog during a lab experiment where the dog’s heart stopped while we were monitoring it with an EKG machine. Afterward, I looked at the tape and saw the regular rhythm followed with a short stretch of flat line, then the spike from my thump followed by a normal rhythm once again. Because of that, I still do the pre-cordial thump regardless. It only takes a moment and in my opinion, there is nothing to lose.

More recently, it has been suggested that the pulmonary (P) part of CPR does not need to be done. A few studies suggest that chest-compression-only CPR or CCR may be just as effective or possibly even better than CPR with rescue breathing. These studies involve people performing the resuscitation in non-hospital settings and often with little or no CPR training.

There is no question that without an effective cardio part of the resuscitation it will not work, so if we have to chose one or the other, chest compressions are paramount. The newer recommendations, which I do agree with, suggest 30 compressions — rather than the older 15 — to two breaths so that the body is sure to receive the oxygen it needs to survive in the first few minutes after the cardiac event. I also understand people not wanting to do mouth-to-mouth without some type of barrier for their own protection. However, as I said to my father this week, “If I have to do CPR on you, you are getting the breathing!”

On CPR Training

I recently saw a study on male and female medical students performing CPR out of Switzerland. The study, “Influence of Gender on the Performance of Cardiopulmonary Rescue Teams: A Randomized, Prospective Simulator Study,” looked at the influence of gender on resuscitation performance. The aim of this study was to compare female and male rescuers in regard to cardiopulmonary resuscitation and leadership performance with the goal of improving any issues by the application of appropriate correctional educational methods.

Using 216 volunteer medical students (108 females and 108 males), the study found that female rescuers showed inferior cardiopulmonary resuscitation performance, which can partially be explained by fewer unsolicited cardiopulmonary resuscitation measures and inferior female leadership. Specifically, female-only teams showed less hands-on time and a longer delay before the start of chest compressions, a lower leadership performance in different domains, fewer unsolicited cardiopulmonary resuscitation measures, and a lower number of secure leadership statements. The study concluded that “the future education of rescuers should take gender differences into account.”

I think there are some weaknesses in this study. I do not see where they were measuring effective physical CPR, only decision making and time till initiation of CPR, and the differences were only measured to be in seconds. If the CPR is not physically effective, it is useless. If you are a little slower to initiate CPR yet do it better, I imagine the overall survival rate would be better. The other thing is, this study was done on mannequins. CPR on a living, soon to die, person, with only your skills making the difference is a whole different scenario.

I suggest in the training of medical students, rather than target one gender for additional training, raise the training for emergencies for all students to as high a level as is humanly possible.

It goes without saying, but I’ll say it anyway, if you are not already certified, please learn CPR.